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   Table of Contents - Current issue
Coverpage
April-June 2019
Volume 68 | Issue 2
Page Nos. 97-173

Online since Tuesday, October 15, 2019

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EDITORIAL  

Decline in interest of medical graduates to do postgraduation in anatomy and how do we resolve it? p. 97
Vishram Singh
DOI:10.4103/JASI.JASI_133_19  
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ORIGINAL ARTICLES Top

The toxicological and histopathological effects of aqueous and ethanolic extracts of Cyperus rotundus rhizomes in ehrlich ascites carcinoma induced in Swiss albino mice p. 99
Hema Nidugala, Ramakrishna Avadhani, Ashwini Prabhu, B Ravishankar
DOI:10.4103/JASI.JASI_101_19  
Introduction: Cyperus rotundus, commonly known as mustha, is a perennial weed and possesses the ability to adopt to various soil types, temperatures, and moisture levels. It has several pharmacological and medicinal applications such as astringent, diuretic, antispasmodic, carminative, vermifuge, and antimicrobial properties. This study was designed to assess the toxicological and histopathological effects of aqueous and ethanolic extracts of C. rotundus rhizomes in Ehrlich ascites carcinoma (EAC)-induced Swiss albino mice. Material and Methods: Toxicity evaluation was carried out according to the OECD guidelines and histopathological assessment of the liver and kidney tissues was made using hematoxylin and eosin staining. Results: Results indicated that both ethanolic and aqueous extracts did not induce any toxicity up to 2000 mg/kg body weight doses. Examination of ascitic fluid revealed that ethanol extract at 250 mg/kg dosage induced degenerative changes, whereas aqueous extract at both dosage levels showed mild signs of apoptosis. Gross pathology of the liver and kidney indicated that the extracts did not alter the normal cytoarchitecture of these tissues. Discussion and Conclusion: Findings from this study interpret that C. rotundus rhizome extracts can be used as a complementary therapeutic in the EAC.
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Anomalous origin of the obturator artery in a Goan population: A study linked with hernia reduction surgery p. 105
Medora Celine D'Souza Dias, Rajesh T Patil
DOI:10.4103/JASI.JASI_27_19  
Introduction: The “corona mortis” or “crown of death” occurs when an accessory obturator artery (OA) is also present, having rich anastomosis with the normal OA around the obturator canal. The OA can take origin from various arteries such as the common iliac, anterior or posterior divisions of the internal iliac, inferior epigastric, superior or inferior gluteal, internal pudendal, or even external iliac arteries. Accessory OA has an incidence of 30%–40% in earlier studies.To find out the incidence, location, and dimensions of aberrant, retropubic, anastomosing vessels and the corona mortis that connects the external iliac and obturator vessels and to determine their interference with various surgical approaches. Material and Methods: Twenty-five cadaveric pelvises were dissected in the pelvic and retropubic inguinal regions. The origin and course of the OA and the presence of venous plexuses were recorded. We studied the frequencies of occurrence of abnormal obturator vessels and also their variant patterns of origin from and drainage into the iliac vessels. Student's t-test was the statistical analysis used. Results: We found a higher incidence, i.e., 44% of internal iliac artery branching pattern as Group Ia. Vasa corona mortis was seen in two pelvises showing an arterial connection around the superior pubic ramus, whereas venous corona mortis was seen in twenty pelvises and five hemipelvises showing an aberrant OA. Discussion and Conclusions: Cadaveric dissections have shown a vascular connection between the obturator, external iliac, and inferior epigastric vessels, and these variations are important specially when doing pelvic and groin surgeries.
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Typical thoracic vertebrae morphometry: A cadaveric study in Nigeria Highly accessed article p. 110
OA Egwu, GN Okechukwu, GC Uzomba, SO Eze, UK Ezemagu
DOI:10.4103/JASI.JASI_8_19  
Introduction: Spine morphometry is of global interest because of its great importance in prosthetics, orthopedics, and biomechanics. The present study was carried out to provide a comprehensive morphometric data of typical thoracic vertebrae in Nigeria. Material and Methods: A total of 208 typical thoracic vertebrae which consist of 26 set of macerated adult male vertebrae, were studied by direct measurements of the vertebral body, vertebral foramen, pedicle, lamina, spinous and transverse processes, and superior and inferior articular processes. Digital Vernier Caliper was used to measure internal and external distances. Data collected were statistically analyzed and mean values were presented in a mean ± standard deviation. Results: Anterior vertebral body height (VBH) gradually increased to a maximum value at T9 (18.83 ± 1.54 mm) and minimum at T2 (16.93 ± 1.57 mm). Mean value of posterior VBH was minimum at T2 (17.59 ± 1.43 mm) and maximum at T9 (20.46 ± 3.08 mm). Width of spinous process tip had relatively stable values from T2 to T9 with the maximum at T2 (5.05 ± 1.36 mm). Lamina thickness mean values were relatively stable from T2 to T9 with a maximum value at T9 level (7.30 ± 1.24 mm) and the minimum at T2 (6.60 ± 1.16 mm). Discussion and Conclusion: Superior and inferior articular surfaces and Laminae were reported for the first time which contributes to the novelty of this study. These findings will serve as a guidepost in the understanding and design of well-fitted materials for the typical thoracic vertebrae, which will enhance preclinical and clinical evaluation of vertebral implants, prosthetics, and management of spine pathology.
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Gestational diabetes alters the expression of genes involved in Sertoli cells maturation in testis tissue from adult rat offspring Highly accessed article p. 119
Zahra Nazari, Soraya Ghafari, Mohammad Jafar Golalipour
DOI:10.4103/JASI.JASI_22_19  
Introduction: Previous Studies indicate that both type 1 and 2 diabetes mellitus have adverse effects on the male reproductive system. Furthermore, it has recently shown that induced gestational diabetes significantly reduces the Sertoli cells number in the rat offspring. This study was done to evaluate the effect of gestational diabetes mellitus (GDM) on the expression of genes involved in Sertoli cell proliferation and maturation in the adult rat offspring. Material and Methods: To test this hypothesis, 12 Wistar rat dams were randomly allocated to control and diabetic groups. The diabetic group received 40 mg/kg/body weight of streptozotocin on day 0 of gestation. After delivery, six offspring of each group at the age of 12 weeks scarified and testis tissue harvested. After RNA extraction, the expression of p27kip1, A-kinase anchoring protein 9, CX43, and aromatase genes in both groups was evaluated by quantitative real-time polymerase chain reaction. Results: Our data showed that the expression of all examined genes which are important in Sertoli cells maturity and function were lower in GDM offspring. p27kip1 and aromatase were significantly downregulated in GDM offspring by 57% and 41%, respectively (P * 0.05*). Discussion and Conclusion: In summary, we provide evidence that GDM may adverse effects on the male reproductive system in the offspring by alterations in the expression of genes responsible for Sertoli cell proliferation and differentiation.
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Lumbosacral transitional vertebrae in patients with low back pain: Radiological classification and morphometric analysis p. 123
Priyanka Daniel, Jerry Joseph Joel, Parminder Kaur Rana
DOI:10.4103/JASI.JASI_61_19  
Introduction: Lumbosacral transitional vertebrae (LSTV) are a congenital variation found in patients incidentally. The aim of this study was to find the prevalence of LSTV and to study its morphometric parameters radiologically in comparison with patients with no LSTV, in low back pain patients in Punjabi population. Material and Methods: The anteroposterior (AP) and lateral lumbosacral spinal radiographs of 100 patients with low back pain were studied. LSTV were identified and classified based on the Castellvi classification. The width of the transverse processes, superior and inferior vertebral end plate, mid-AP diameter and height of the L5 vertebra, and L5–S1 disc height were measured. All parameters were statistically analyzed and compared between normal and LSTV patients. Results: LSTV were found in 22% of low back pain patients, all comprising sacralization of L5, most common Castellvi type being IIA (31.9%). There were a statistically significant increase in the width of transverse processes of L5 vertebrae on both the right and left sides (P < 0.001 each) and a significant increase in height of L5 body (P = 0.03), with a decrease in L5–S1 disc height (P = 0.05) in low back pain patients with LSTV in comparison with patients without LSTV. Discussion and Conclusions: LSTV is a common congenital anatomical variation found in patients with low back pain. An increased height of L5 vertebra with a decreased L5–S1 disc height is found to be related to LSTV and can be useful for radiologically suspecting LSTV in patients with low back pain.
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Perspective of the 1st year undergraduate medical students in learning anatomy p. 129
Rohini Punja, Suhani Sumalatha, Mamatha Hosapatna
DOI:10.4103/JASI.JASI_59_19  
Introduction: Anatomy, one of the basic sciences' subject of the 1st year medical education curriculum, is recognized as an essential foundation for clinical sciences. However, there is a continuing debate on the best method of learning anatomy. In this study, we infer the perception of the 1st year medical students on the best method of learning anatomy. Material and Methods: The present study was conducted on 246 1st year undergraduate medical students, of the academic year 2015–2016. An online platform – Survey Monkey – was utilized to conduct the survey where multiple-answer multiple-choice questions were sent to the students, and the results were tabulated on a graph. Results: The optimal way of learning anatomy according to 80% of students was through small-group teaching in comparison to didactic lectures according to 12%. Integrated teaching introduced as talks by physicians (31%) and problem-based learning (28%) was not well appreciated. However, they felt an exposure to the clinical side where small groups are taken to the hospital to demonstrate relevant case/procedure/examination would have a more significant impact (78%). There was a favorable opinion (74%) on the formation of an Anatomy mentor cell where the students who had performed poorly during the first sessional test were under the guidance of anatomy staff, and regular assignments were given. Discussion and Conclusion: Anatomy exposes the student to an ocean of knowledge; it also inculcates a particular attitude and communication toward another human being. The students' perspective in learning Anatomy plays a crucial role in the changing times and demand reforms which would best aid the student-centric learning.
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Is the trend of brachycephalization more advanced in females than males: An observational study on medical students in a rural medical college of Himachal Pradesh, North West Of India p. 133
Vandana Sharma, Suman Yadav, Vishal Kalia, Daisy Dwivedi, Girish Kumar, Priyanka Dhiman
DOI:10.4103/JASI.JASI_13_19  
Introduction: The cephalic index (CI) was defined by Swidesh Professor of Anatomy Anders Retzius as a percentage of width to length in the skull. Head dimension changes follow a pattern in different populations. CI is used to determine the racial variation and sexual difference among the individual whose identity is unknown and to investigate the craniofacial deformities and brain development. Material and Methods: Himachali MBBS students of Dr. RPGMC, Tanda who satisfy the inclusion criteria were approached for consent to participate in the study. Detailed history, including birth history (including the place of birth), socio-economic history, and history of migration, was taken, and anthropometric examination was done by the investigator, as per the standard protocol. Results: We studied 77 medical students at Dr. RPGMC, Kangra at Tanda Himachal Pradesh, of which 40 (51.94%) were males and 37 (48.05%) were females. The mean age of all the students was 19.05 years. The mean head circumference of all the students was 54.31 ± 1.8 cm and minimum of 49.0 cm and maximum of 58.2 cm. Mean CI of the group was 77.85 ± 4.43. Male group had the mean CI of 76.96 ± 4.00. Female group had mean CI of 78.83±4.7 Most 18 (45%) of the male students had mesocephalic head shape and in female groups, 15 (40.5%) also had mesocephalic head shape. Discussion and Conclusion: From this study, we conclude that the dominant head shape is mesocephalic in both male and female, but the tendency of brachycephalization is more advanced in the female adult population of Himachal Pradesh.
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Body mass index in adult jaunsari tribe population of Dehradun district of Uttarakhand p. 138
Kumar Satish Ravi, Mukesh Singla, Mohd Salahuddin Ansari
DOI:10.4103/JASI.JASI_51_19  
Introduction: Obesity is one of the major risk factors for cardiovascular diseases. It is one of the defining components of cardiometabolic syndrome. Several indices are there for measurement of obesity, but body mass index (BMI) is relatively better than others and can be measured by the individual himself/herself. There is lack of such study for Jaunsari tribe population of Dehradun district of Uttarakhand. These values can also be used as standard for future reference for Jaunsari population. The study was planned to study parameters related to BMI in adult Jaunsari tribe of district Dehradun, Uttarakhand. The objectives of the study were: (1) to study BMI and the parameters related to it in adult male and female population of Jaunsari tribe of Dehradun district in Uttarakhand, (2) to analyze the sex differences in these parameters, and (3) to analyze statistical significance of the difference. Material and Methods: The study was carried on 100 adult males and 100 adult females of >18 years of age, belonging to Jaunsari tribe, after due approval from the institutional ethical committee and informed consent. The methodology adopted for the anthropometric measurements was of Singh and Bhasin (1968), and concerned measurements were done. Results: The mean weight, height, and BMI are found to be 50.90 ± 9.92 kg and 59.81 ± 10.74 kg, 152.43 ± 5.63 cm and 165.39 ± 7.23 cm, and 21.90 ± 4.05 and 21.85 ± 3.65 in female and male Jaunsari population, respectively, with statistically significant variation in both weight and height across gender with little or no variation in BMI. Standing height of majority of females falls under class short (54%) or very short (39%), whereas 32% of males are tall, 21% are lower medium, and 22% are short. This means that BMI falls into the category of “normal weight". Discussion and Conclusion: Hence, it is concluded that the mean BMI is 21.90 ± 4.05 kg and 21.85 ± 3.65 kg in female and male Jaunsari population, respectively, which falls into the category of “normal weight.” This may be attributed to their traditional lifestyle and typical geographical location. This can be used as standard for future reference for Jaunsari population.
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Effects of stress-induced depression and antidepressant drugs on CA3 region of hippocampus in adult albino rats p. 143
Nazim Nasir, Atiq ul Hassan, Izhar Husain
DOI:10.4103/JASI.JASI_16_19  
Introduction: Hippocampus is the most extensively studied part of the brain in recent years. The connections of the hippocampus are extensive and very complicated, covering lots of functions in the body. The aim of the study is to find out the effect of stress-induced depression in the CA3 region of the hippocampus and also to see the effect of antidepressants for the reversal of changes in the similar area. Material and Methods: The study conducted on adult albino rats weighing 200–250 g. The study involved 50 albino rats and divided into five groups. The first group was control of ten rats and received water and food ad libitum, and the second group was experimental having two subtypes E1 and E2 receiving 4 weeks and 7 weeks immobilization with ten rats each, respectively. The third is treatment group which has two subtypes T1 and T2 for 4- and 7-week treatment by fluoxetine drug (1 mg/kg body weight orally) with ten rats each, respectively. The animals sacrificed after the experiment, perfused with 10% formaldehyde, brains dissected, and tissue blocks processed for paraffin embedding. Observations were made on 5-μ thick H and E-stained sections. Estimation of neuronal density of CA3 regions performed using Motic Images Plus 2.0 software (Hong Kong China). Results: Neuronal density was markedly reduced (98.7 ± 6.1 cells/cubic mm) in acute depression and 66.3 ± 4.8 cells/cubic mm in chronic depression group, respectively, as compared to control (124.5 ± 7.2 cells/cubic mm). The density improved after giving drug treatment. Neuronal density was 111.2 ± 9.6 cells/cubic mm and 92.3 ± 5.5 cells/cubic mm in 4- and 7-weeks treatment, respectively. Discussion and Conclusion: These results suggested that neurodegenerative effects of depression on the hippocampus, which is reversed by giving antidepressant drug.
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Active learning methodology – jigsaw technique: An innovative method in learning anatomy p. 147
Monika Lalit, Sanjay Piplani
DOI:10.4103/JASI.JASI_57_19  
Introduction: For years together, gross anatomy is taught by the traditional teacher-oriented teaching method, i.e., students have to attend the lecture classes followed by the dissection on cadavers. In general, most of the students find it difficult to understand and retain gross anatomy. Active learning (AL) has received considerable attention over the past several years and is often contrasted to the traditional lecture where students passively receive information from the instructor. Class time is also brief and precious, and the information we want to communicate to our students is also important. AL Methodology (ALM) by jigsaw technique encourages active student participation, maximizes their own and each other's learning, and improves their communication skills which can be applied beyond anatomy to their careers as future physicians. The aim of the study is to assess the effect of implementation of AL method as a learning tool on the learning and performance of 1st-year medical students. Material and Methods: The project was carried out in the Department of Anatomy comprising 150 first professional MBBS students. Sensitization session with students and faculty was done. Two topics already taught by traditional didactic lecture were chosen for the jigsaw technique. Effectiveness of learning experience was evaluated by the students and faculty through a prevalidated feedback questionnaire with a five-point Likert scale to record their experiences, perception, and attitude toward the ALM (jigsaw). Results: The findings of student's feedback on five-point Likert scale revealed that the students were in favor that ALM was helpful in improving the learning skills and major topics should be taught by this AL methodology. Discussion and Conclusion: The study results show that ALM jigsaw technique is an effective teaching method. ALM by jigsaw technique motivated and encouraged active student participation and discussions. Students and faculty both favored the use of ALM.
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Teeth as an anatomical modality for age estimation using radiographic approach p. 153
Kusum Singal, Neelkamal Sharma, Permila Singh, Vikas Kumar
DOI:10.4103/JASI.JASI_89_19  
Introduction: Age estimation of adult individuals represents an important part of forensic anthropology, forensic medicine, forensic osteology, and forensic dentistry. Teeth proved to be a perfect anatomical tool for age estimation. The study was performed with aim to evaluate the coronal pulp cavity index (CPCI) using radiographic approach and to correlate the CPCI with the real age, i.e. chronological age of the individuals. Material and Methods: CPCI was radiographically evaluated using radiovisiographs (RVGs) of 320 individuals (160 males and 160 females) having age range of 15–54 years. The sample comprised of 1280 RVGs of 4 teeth per individual (maxillary canine, maxillary second premolar, mandibular canine, and mandibular first premolar). Two radiographic measurements were performed on all radiographs. One is coronal pulp height and another one is height of crown (coronal height). CPCI for each radiograph was calculated and correlated with the chronological age of the study individuals using statistical software SPSS (Version 21). Results: Intra-observer agreement of CPCI measurements was almost perfect. The accuracy of regression models, when applied to different set of radiograph samples, was within acceptable range of differences in the forensic anthropology. Discussion and Conclusions: All the selected teeth showed a strong negative correlation with the chronological age. However, all selected teeth do not have equal applicability for age estimation suggesting that further evaluation on different samples for teeth specific regression models for age estimation.
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Ultrastructural demonstration of telocytes in human postpartum Fallopian tube p. 159
B Minu Rekha, Santhosh Joseph Benjamin, Suganthy Rabi
DOI:10.4103/JASI.JASI_40_19  
Introduction: Telocytes are an unique type of cells found in the interstitial tissue of various organs including the female reproductive tract. These cells are recently being implicated in various functions, including tissue repair and regeneration. They are associated with nerve endings, but their association with blood vessels and immune cells has not been established in the Fallopian tube unlike the telocytes seen in the uterus. This study aims to look for the association of telocytes with blood vessels and immune cells in the human postpartum Fallopian tube. Material and Methods: Ten postpartum Fallopian tube samples from the ampulla were obtained from the patients who underwent lower segment cesarean section with sterilization by the modified Pomeroy's technique. The samples were processed for electron microscopy and studied under a transmission electron microscope. Results: The human postpartum Fallopian tube showed increased microvasculature. Telocytes were found to be located in the mucosal and the muscular layers of the human postpartum Fallopian tube, predominantly in the subepithelial layer of the lamina propria. They were seen in association with blood vessels, especially high endothelial venules and immune cells such as mast cell and lymphocytes. Discussion and Conclusion: Telocytes seen in association with the blood vessels, especially high endothelial venules and immune cells in the human postpartum Fallopian tube suggest their probable role in the complex interplay in the immune tolerance and immune surveillance of the postpartum Fallopian tube.
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Students' perception on anatomy education in Cyberjaya University College of Medical Sciences, Malaysia p. 163
Atikah Abdul Latiff, Saheera Kamarzaman, Norhafizah Ab Manan, Krishna Gopal Rampal, Bala Krishnian Muniandy
DOI:10.4103/JASI.JASI_46_19  
Introduction: Anatomy education faces continuous debate about the best teaching methods to maximize learning as sufficient knowledge of anatomy is crucial for safe and efficient clinical practice. This study was conducted to explore students' perceptions about learning anatomy by focusing around six major topics: (i) the importance of anatomy in medical school, (ii) factors influencing students' performance in anatomy, (iii) anatomy teaching methods, (iv) continuous assessment in anatomy, (v) the clarity of learning outcomes, and (vi) students' suggestions to improve anatomy learning. Material and Methods: A total 183 medical students from year 1 to year 5 currently studying in Cyberjaya University College of Medical Sciences participated in the survey. This study involved collecting data through the Anatomy Education Questionnaire via online survey link. Results: There is a general awareness among all students regarding the importance and relevance of anatomy, i.e., to be a safe and competent doctor (80.7%) and to be able to perform invasive procedures and surgeries on patients (79.1%). Majority of students feel that inadequate assessments (59%), integrated curriculum (53%), and inappropriate teaching methods (31%) are the major factors that influence students' performance in anatomy. Teaching anatomy via cadaveric dissection (72.2%) is the most preferred study tool whereas traditional lectures (29.9%) are the least preferred methods among the students. Majority of students (97.3%) agree that having more continuous assessments helps them identify their weaknesses in anatomy. Discussion and Conclusions: This study suggests the necessity for some educational refinements to improve anatomy learning by fostering deeper approaches via clinical integration of the subject and utilization of anatomy videos.
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